Nephrotic Syndrome — Clinical

A 52-year-old man with a 10-year history of type 2 diabetes mellitus presents with progressive bilateral ankle edema, foamy urine, and dyspnea on exertion for 2 months. His blood pressure is 158/94 mmHg. Laboratory investigations reveal: serum creatinine 2.8 mg/dL, blood urea 68 mg/dL, serum albumin 2.4 g/dL, 24-hour urine protein 6.5 g, serum sodium 132 mEq/L, potassium 5.8 mEq/L. Urinalysis shows 3+ proteinuria, 2+ hematuria, and occasional hyaline casts. Renal ultrasound shows bilateral kidney size 9 cm with increased echogenicity. Serum complement C3 and C4 are normal. Which of the following is the most likely diagnosis?

A 28-year-old man with biopsy-proven minimal change disease (MCD) presents with nephrotic syndrome (proteinuria 8 g/day, serum albumin 2.1 g/dL). He is started on high-dose corticosteroids but after 4 weeks shows no response (persistent proteinuria >3.5 g/day). What is the drug of choice for steroid-resistant minimal change disease?

A 35-year-old Indian woman presents with nephrotic syndrome (proteinuria 8 g/day, serum albumin 2.1 g/dL, edema). Renal biopsy shows diffuse proliferative glomerulonephritis with subepithelial 'hump-like' deposits on electron microscopy. What is the most common cause of nephrotic syndrome in this clinical presentation?

A 35-year-old woman presents with nephrotic syndrome (proteinuria 8 g/day, serum albumin 2.1 g/dL, edema). Renal biopsy shows membranous nephropathy. Regarding the complications and management of nephrotic syndrome, all of the following are true EXCEPT:

A 28-year-old woman presents with progressive swelling of the face and legs over 3 weeks. She reports sudden-onset foamy urine and weight gain of 8 kg. On examination: BP 128/82 mmHg, bilateral pitting pedal edema, ascites. Laboratory findings: serum albumin 2.1 g/dL, total protein 4.8 g/dL, 24-hour urine protein 8.2 g, serum creatinine 0.9 mg/dL, blood urea 28 mg/dL. Lipid profile shows total cholesterol 320 mg/dL, LDL 240 mg/dL. Urinalysis: 4+ proteinuria, few RBCs, no casts. Renal ultrasound: normal-sized kidneys, normal echotexture. Serum complement C3 and C4 levels are normal. Which of the following is the most likely diagnosis?